Opioid misuse is an accelerating public health crisis in the United States. Increasing attention has been directed towards surgical sources of opioid over-prescription. To better inform efforts to improve the safety of post-operative analgesia, we aimed to examine factors associated with opioid prescribing practices following urological surgery.

METHODS

We used a centralized electronic health record (EHR) system platform at a multi-site academic medical center to identify patients who underwent short stay and ambulatory urologic surgeries from January to December 2016. Dispensed opioid doses were extracted from the Epic EHR. Using standard conversion factors, we calculated equivalents of 5mg of oxycodone, which were characterized as high (> 30 5mg oxycodone tablets) or low (≤ 30). We tabulated and compared clinical, demographic, surgical, and provider characteristics across prescription dose thresholds using descriptive statistics. Multivariable logistic regression was used to assess factors associated with high dose therapy.

Using an enterprise wide EHR clinical informatics tool, we observed significant variation in opioid prescription following urological surgery. Patients with a history of psychiatric diagnosis received higher doses. Efforts are warranted to optimize estimates of opioids required postoperatively to improve safety.